Effectiveness and safety of COVID-19 vaccines in patients with diabetes as a factor for vaccine hesitancy

Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality,prolonged hospital stay,and requirement of invasive mechanical ventilation.This review aims to present the effectiveness and safety profile of available coronavirus disease 2019(COVID-19)vaccines in people with diabetes as a potential cause of hesitancy for vaccination.Data from published research proves a robust immune response following immunization for COVID-19 in diabetic patients with substantial production of virus-neutralizing antibodies;however,the observed immune response was unequivocally weaker than that in individuals without diabetes.This observation was further enhanced by the findings that worse glycemic control was associated with more suppressed antibody production.In contrast,individuals with optimal glycemic control performed similarly to healthy controls.In addition to the need for strict glucose monitoring and adequate diabetes treatment,those findings reinforce the concept of diabetes-induced secondary immune deficiency and necessitate the application of booster doses to diabetic patients with priority.Nevertheless,after vaccination,reported adverse events were not different from those in the general population.No increase in severe adverse events was documented.While single case reports detected transient increases in blood glucose post-vaccination,more extensive trials could not replicate such a relationship.

Effectiveness of ChAdOx1 nCoV-19 coronavius vaccine in preventing severe disease and mortality during the second wave of pandemic:A case-case analysis from a tertiary care center in South India

Objective:To determine the real-world effectiveness of the ChAdOx1 nCoV-19 coronavirus vaccine in preventing severe disease and mortality due to COVID-19.Methods:A case-case design was used to estimate the effect of the ChAdOx1 nCoV-19 coronavirus vaccine on severe SARS-CoV-2 outcomes in individuals aged 40 years and above.Cases(n=200)were COVID-19 patients admitted to intensive care unit(ICU)or who died.Controls(n=223)were those with mild COVID-19,fit for home isolation.The logistic regression model was used to estimate adjusted vaccine effectiveness for full vaccination(two doses≥14 d)and partial vaccination status(one dose≥14 d or two doses<14 d).Results:The proportion of fully vaccinated individuals was significantly lower among cases(12,6.0%)compared to controls(30,13.5%).The adjusted effectiveness of a full dose of ChAdOx1 nCoV-19 coronavirus vaccine in preventing ICU admission or death was 81.9%(95%CI:61.3%-91.6%,P=0.001).Subgroup analysis restricted to age group,sex,and comorbidities found that ChAdOx1 nCoV-19 coronavirus vaccine had a significant positive effect in all subgroups and categories.Conclusion:COVID-19 vaccination reduces ICU admissions or death.Therefore,increased vaccine uptake may reduce the severity of the pandemic,more so in the elderly and those with comorbidities.

Modeling the Infection Disease (Covid-19) and the Effect of Vaccination

In this paper we provide different types of approach in mathematical biology about infection disease and understanding the dynamic of epidemic mathematical models specially in COVID-19 disease which first outbroke in China and fast spread around the world. We work in the connection between the mathematical models and the solution analytically and numerically. At first, we emphasize the Susceptible-Infectious-Recovered (SIR) models’ extension for policy significance. Then, we found the improved SIER model done by research. In third section, we examine the improved model when an appropriate vaccine has been found, we introduce the model of SIR with vaccine term which ends up with discussion and conclusion about the effect of vaccinate. The comprehension of COVID-19 transmission methods, structures, and characteristics is greatly aided by these mathematical models analytically and numerically.

Epidemic of Rabies and Effect of Its Vaccine against a Dog That Consecutively Attacked Ten People in One Day

On December 21, 20：10, a stray dog consecutively attacked 10 people in Lengshui Village, Ningyuan County, Yongzhou City, Hunan Province, China. The dog was killed by the local CDC staff and vicinity villager, its brain tissue sample was taken within 24 h. The epidemic focus was disinfected and the injured people received post exposure prophylaxis （PEP）. Pathogens were detected in the tissue sample by the provincial CDC. The immunity and safety of rabies vaccine were assayed after PEP, the injured people were regularly followed up in the following 2 y and 6 mon.

Immunotherapeutic effects of dendiritic cells vaccine pulsed with tumor cell lysate in mice with pancreatic carcinoma

Objective To observe the immunotherapeutic effects of dendritic cells vaccine pulsed with tumor cell lystate on mice with pancreatic carcinoma. Methods Dendritic cells (MTSC4) were pulsed with tumor cells lysate. The immune preventative and immnotherapeutic effects of DC vaccines on mice with pancreatic carcinoma were assessed. Results After vaccination of the DC vaccines,mice remained tumor-free for at least 25 days in DCs vaccines group,but in other groups the subcutaneous implantation tumorigenesis were found beginning 3 to 9 days. CTL stimulated by DC vaccines effected cytolytic activity against pancreatic carcinoma cells. The survival period was obviously prolonged in DCs vaccines group (56 ±9)d than in other groups P【0.01) and tumors (1.4 ±0.8)g in DCs vaccines group were significantly smaller than that in other groups (P 【 0. 05). Conclusion Tumor cell lysate-pulsed dendrtic cells vaccines can induce a specific and effective immune response against pancreatic carcinoma cell implanted in mice.

Anti-tumor effects induced by gene vaccines co-expressing truncated human prostate specific membrane antigen gene and mouse 4-1BBL

Objective To investigate the influence of m4-1BBL on anti-tumor effects induced by truncated human prostate specific membrane antigen ( tPSMA ) gene in mice. Methods A eukaryotic expression plasmid encoding tPSMA and m4-1BBL ( pDC316-tPSMA-IRES m4-1BBL) ,pDC316-tPSMA and pDC316 were constructed.

Reasons of Vaccine Hesitancy among Pakistanis with Available COVID-19 Vaccine: The Next Challenge in the Fight against COVID-19

The government of Pakistan started vaccination campaign for the frontline healthcare pro-viders, as they are more likely to be exposed to COVID-19 patients. In the next step, it ex-tended the free vaccination campaign to include people above 60 and 50 years of age re-spectively. The drive is now open to all citizens >18 years of age. There is a significant re-luctance to get vaccinated even though the government has provided it free of cost. The project uses self-reporting method to assess reasons of vaccine hesitancy among Pakistanis and possible solutions to overcome this problem. Concern for serious side effects was the most common issue 154 (48.42%) reported among all groups of people, including the healthcare workers. The major sources of COVID-19 related information were television 117 (36.8%) and healthcare professionals 105 (33%). The participants reported that they can be convinced to get vaccinated if more published data related to vaccine efficacy and safety is available 118 (37.1%), they observe no side effect among vaccine recipients 90 (28.3%) or higher government officials get the same vaccine 39 (12.3%). Vigorous analysis and publication of data generated is paramount to increase the percentage of people being vaccinated. The healthcare professionals should share evidence-based knowledge related to vaccine efficacy and safety through television and social media to increase acceptance rates and hence, decrease mortality and morbidity from COVID-19 in Pakistan.

Current state of knowledge on the excretion of mRNA and spike produced by anti-COVID-19 mRNA vaccines;possibility of contamination of the entourage of those vaccinated by these products

The massive COVID-19 vaccination campaign is the first time that mRNA vaccines have been used on a global scale.The mRNA vaccines correspond exactly to the definition of gene therapy of the American and European regulatory agencies.The regulations require excretion studies of these drugs and their products(the translated proteins).These studies have not been done for mRNA vaccines(nor for adenovirus vaccines).There are numerous reports of symptoms and pathologies identical to the adverse effects of mRNA vaccines in unvaccinated persons in contact with freshly vaccinated persons.It is therefore important to review the state of knowledge on the possible excretion of vaccine nanoparticles as well as mRNA and its product,the spike protein.Vaccine mRNA-carrying lipid nanoparticles spread after injection throughout the body according to available animal studies and vaccine mRNA(naked or in nanoparticles or in natural exosomes)is found in the bloodstream as well as vaccine spike in free form or encapsulated in exosomes(shown in human studies).Lipid nanoparticles(or their natural equivalent,exosomes or extracellular vesicles(EVs))have been shown to be able to be excreted through body fluids(sweat,sputum,breast milk)and to pass the transplacental barrier.These EVs are also able to penetrate by inhalation and through the skin(healthy or injured)as well as orally through breast milk(and why not during sexual intercourse through semen,as this has not been studied).It is urgent to enforce the legislation on gene therapy that applies to mRNA vaccines and to carry out studies on this subject while the generalization of mRNA vaccines is being considered.

COVID-19 outbreaks in residential care homes in Hong Kong and effectiveness of vaccine against severe outcomes

Background:COVID-19 outbreaks in residential care homes for the elderly(RCHEs)and for persons with disability(RCHDs)have caused significant morbidity and mortality during 5th epidemic in Hong Kong.This article reviewed COVID-19 outbreaks situation and estimated the effectiveness of receiving at least two-dose of COVID-19 vaccine in preventing severe outcomes.Methods:To estimate attack rates and vaccination coverage,documentation on COVID-19 infection and their vaccination records of residential care homes(RCH)residents reported between December 31,2021 and May 31,2022 were reviewed,and infected cases were follow-up for 4 weeks for severe outcomes or death.Correlation between vaccination coverage against attack rate by types of homes was examined.Infected RCH residents with available information were included in the analysis of vaccine effectiveness against severe outcomes and death.Results:COVID-19 vaccination coverage was low in RCHDs(median 0.46,IQR:0.24-0.76)and very low in RCHEs(median 0.08,IQR:0.00-0.19).Higher attack rates were recorded among RCHE residents(median 0.84,IQR:0.64-0.93)and higher case fatality rate(CFR:28.1%)than in RCHDs(median 0.58,IQR:0.31-0.84;CFR:3.9%).The attack rate decreased when vaccination coverage increased for both RCHEs(ρ=−0.131,p<0.001)and RCHDs(ρ=−0.333,p<0.001).Comparing with infected residents who were unvaccinated/vaccinated with one-dose,receiving at least two-dose was estimated to be effective in reducing severe outcomes in 31%and 36%of infected RCHE and RCHD residents respectively;with greater reduction in mortality among RCHD than RCHE residents(54%and 38%,respectively).Vaccine effectiveness of two-dose of BNT162b2 against severe outcomes and death are higher than that of CoronaVac.Conclusions:Increasing COVID-19 vaccination could have significant impact on reducing the risk of COVID-19 outbreaks in RCHs.At least two-dose of COVID-19 vaccine is still effective in reducing severe outcomes and death among infected residents in RCHs during Omicron epidemic.

Omicron Infections in Otolaryngology Practice: A Retrospective Observational Study on Testing, Symptoms and Vaccination Status

Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.

Effectiveness of rotavirus vaccines against rotavirus infection and hospitalization in Latin America: systematic review and metaanalysis

Background:Rotavirus was the leading cause of childhood diarrhoea-related hospitalisations and death before the introduction of rotavirus vaccines.Methods:We describe the effectiveness of rotavirus vaccines to prevent rotavirus infections and hospitalizations and the main rotavirus strains circulating before and after vaccine introduction through a systematic review and meta-analysis of studies published between 1990 and 2014.203 studies were included to estimate the proportion of infections due to rotavirus and 10 to assess the impact of the vaccines.41 of 46 studies in the post-vaccination period were used for meta-analysis of genotypes,20 to calculate VE against infection,eight for VE against hospitalisation and seven for VE against severe rotavirus-diarrhoea.Results:24.3%(95%CI 22.1–26.5)and 16.1%(95%CI 13.2–19.3)of cases of diarrhoea were due to rotavirus before and after vaccine introduction,respectively.The most prevalent G types after vaccine introduction were G2(51.6%,95%CI 38–65),G9(14.5%,95%CI 7–23)and G1(14.2%,95%CI 7–23);while the most prevalent P types were P[4](54.1%,95%CI 41–67)and P[8](33%,95%CI 22–46).G2P[4]was the most frequent genotype combination after vaccine introduction.Effectiveness was 53%(95%CI 46–60)against infection,73%(95%CI,66–78)against hospitalisation and 74%(95%CI,68.0–78.0)against severe diarrhoea.Reductions in hospitalisations and mortality due to diarrhoea were observed in countries that adopted universal rotavirus vaccination.Conclusions:Rotavirus vaccines are effective in preventing rotavirus-diarrhoea in children in Latin America.The vaccines were associated with changes in genotype distribution.

Virological Characteristics and Prevention and Control of Omicron Sub-lineage BA.2

The Omicron sub-lineage BA.2 has caused a new round of infection of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),leading to a surge in the number of COVID-19 cases in many countries,including China.Because the subvariant BA.2 shows strong infectivity,fast transmission,strong immune escape ability,relatively mild symptoms,strong concealment,difficult to find and so on,it has gradually become a new challenge during the COVID-19 pandemic.Understanding the virological characteristics of Omicron sub-lineage BA.2 is of great significance for epidemic prevention and control.This paper briefly summarizes the virological characteristics and prevention and control strategies of Omicron sub-lineage BA.2.

Molecular Epidemiology and Vaccine Compatibility Analysis of Seasonal Influenza Viruses in Wuhan, 2016–2019

Influenza viruses(FLUV)cause high morbidity and mortality annually in the world and pose a serious threat to the public health.Wuhan,as an important transportation hub in China,has a dense population and suitable climate,which also lays a major hidden danger for the outbreak of influenza.To survey and characterize the seasonal FLUV in Wuhan during 2016–2019,we collected 44,738 throat swabs,among which 15.5%were influenza A(FLUAV)positive,6.1%influenza B(FLUBV)and 0.3%co-infection.By monitoring FLUV in each month from June 2016 to May 2019,different with the previously seasonality pattern,only a single influenza peak was appeared in winter of 2017–2018 and 2018–2019,respectively.These data indicated that the complex circulation pattern of seasonal influenza in Wuhan.In addition,we found the age group was skewed towards 5–14 years group whose activity were mostly school based,which suggested school may be an important place for influenza outbreaks.Meanwhile,phylogenic analysis revealed that two subtypes(subclade 3C.2 a2 and 3C.2 a1b)of A(H3N2)were circulating in Wuhan and there was an obvious transition in 2018 because the two subclades were detected simultaneously.Furthermore,by estimating the vaccine effectiveness,we found that the vaccine strain of FLUAV didn’t seem to match very well the current epidemic strain,especially A(H3N2).Hence,more accurate prediction of seasonal outbreak is essential for vaccine design.Taken together,our results provided the current information about seasonal FLUV in Wuhan which form the basis for vaccine updating.

Research progress in the off-target effects of Bacille Calmette-Guérin vaccine

Bacille Calmette-Guérin(BCG)vaccine is designed to provide protection against tuberculosis(TB).However,numerous epidemiological,clinical,and immunological studies have shown that BCG vaccination affects neonatal and infant mortality,which may be related to the reduction of TB-unrelated infections and diseases by BCG vaccine.We aimed to discuss the off-target effects of BCG vaccine on un-TB infections and diseases,as well as the potential mechanism and influencing factors.Literature was retrieved mainly from PubMed using medical subject headings"BCG,variations,and non-specific,heterologous or off-target".Studies have showed that BCG vaccination can prevent various heterologous infections,including respiratory tract infections,leprosy,and malaria,treat viral infections including human papillomavirus and herpes simplex virus infection as immunotherapy,and improve the immune responses as vaccine adjuvant.Besides,BCG vaccine can reduce the recurrence rate of non-muscle-invasive bladder cancer,and may provide protection against autoimmune diseases.These off-target effects of BCG vaccine are thought to be achieved by modulating heterologous lymphocyte responses or inducing trained immunity,which were found to be sex-differentiated and affected by the BCG vaccine strains,sequence or time of vaccination.

Simulating potential outbreaks of Delta and Omicron variants based on contact-tracing data:A modelling study in Fujian Province,China

Although studies have compared the relative severity of Omicron and Delta variants by assessing the relative risks,there are still gaps in the knowledge of the potential COVID-19 burden these variations may cause.And the contact patterns in Fujian Province,China,have not been described.We identified 8969 transmission pairs in Fujian,China,by analyzing a contact-tracing database that recorded a SARS-CoV-2 outbreak in September 2021.We estimated the waning vaccine effectiveness against Delta variant infection,contact patterns,and epidemiology distributions,then simulated potential outbreaks of Delta and Omicron variants using a multi-group mathematical model.For instance,in the contact setting without stringent lockdowns,we estimated that in a potential Omicron wave,only 4.7%of infections would occur in Fujian Province among individuals aged>60 years.In comparison,58.75%of the death toll would occur in unvaccinated individuals aged>60 years.Compared with no strict lockdowns,combining school or factory closure alone reduced cumulative deaths of Delta and Omicron by 28.5%and 6.1%,respectively.In conclusion,this study validates the need for continuous mass immunization,especially among elderly aged over 60 years old.And it confirms that the effect of lockdowns alone in reducing infections or deaths is minimal.However,these measurements will still contribute to lowering peak daily incidence and delaying the epidemic,easing the healthcare system's burden.

An exploration of the relationship between wastewater viral signals and COVID-19 hospitalizations in Ottawa,Canada

Monitoring of viral signal in wastewater is considered a useful tool for monitoring the burden of COVID-19,especially during times of limited availability in testing.Studies have shown that COVID-19 hospitalizations are highly correlated with wastewater viral signals and the increases in wastewater viral signals can provide an early warning for increasing hospital admissions.The association is likely nonlinear and time-varying.This project employs a distributed lag nonlinear model(DLNM)(Gasparrini et al.,2010)to study the nonlinear exposure-response delayed association of the COVID-19 hospitalizations and SARS-CoV-2 wastewater viral signals using relevant data from Ottawa,Canada.We consider up to a 15-day time lag from the average of SARS-CoV N1 and N2 gene concen-trations to COVID-19 hospitalizations.The expected reduction in hospitalization is adjusted for vaccination efforts.A correlation analysis of the data verifies that COVID-19 hospital-izations are highly correlated with wastewater viral signals with a time-varying rela-tionship.Our DLNM based analysis yields a reasonable estimate of COVID-19 hospitalizations and enhances our understanding of the association of COVID-19 hospi-talizations with wastewater viral signals.